Department of Physiology, Universidade Federal de Sao Paulo, Sao Paulo, Brazil.
Renovo Neural Inc., Cleveland, OH, USA.
Brain Res Bull. 2019 Apr;147:133-139. doi: 10.1016/j.brainresbull.2019.01.011. Epub 2019 Jan 15.
Deep brain stimulation (DBS) refers to the delivery of electric current to specific deep brain structures through implanted electrodes. Recently approved for use in United States, DBS to the anterior nucleus of thalamus (ANT) is a safe and effective alternative treatment for medically refractory seizures. Despite the anti-seizure effects of ANT DBS, preclinical and clinical studies have failed to demonstrate it actions at a whole brain level.
Here, we used a magnetic resonance imaging (MRI)-based approach in healthy adult rats to investigate the effects of ANT DBS through the circuit of Papez, which has central role in the generation and propagation of limbic seizures, in temporal lobe epilepsy (TLE).
After ANT electrode implantation and recovery, ANT DBS and SHAM (sham animals had electrodes implanted but were not stimulated) rats received one single injection of the contrast enhancer, manganese chloride (60 mg/kg, ip). Twelve hours after, rats underwent the baseline scan using the MEMRI (Manganese-Enhanced Magnetic Resonance Imaging) technique. We used the same MEMRI and parvalbumin sequence to follow the DBS delivered during 1 h (130 Hz and 200 μA). Perfusion was followed by subsequent c-Fos and parvalbumin immunostaining of brain sections.
Acute unilateral ANT DBS significantly reduced the overall manganese uptake and consequently, the MEMRI contrast in the circuit of Papez. Additionally, c-Fos expression was bilaterally increased in the cingulate cortex and posterior hypothalamus, areas directly connected to ANT, as well as in amygdala and subiculum, within the limbic circuitry.
Our data indicate that MEMRI can be used to detect whole-brain responses to DBS, as the high frequency stimulation parameters used here caused a significant reduction of cell activity in the circuit of Papez that might help to explain the antiepileptic effects of ANT DBS.
深部脑刺激(DBS)是指通过植入的电极将电流输送到特定的深部脑结构。最近在美国获得批准使用,丘脑前核(ANT)的 DBS 是一种安全有效的治疗药物难治性癫痫的替代方法。尽管 ANT-DBS 具有抗癫痫作用,但临床前和临床研究未能证明其在全脑水平上的作用。
在这里,我们使用一种基于磁共振成像(MRI)的方法,在健康成年大鼠中研究了 ANT-DBS 通过 Papez 回路的作用,该回路在边缘性癫痫(TLE)的发作和传播中具有核心作用。
在 ANT 电极植入和恢复后,ANT-DBS 和 SHAM(假动物有电极植入但未刺激)大鼠接受了一次对比增强剂氯化锰(60mg/kg,ip)注射。12 小时后,大鼠使用 MEMRI(锰增强磁共振成像)技术进行基线扫描。我们使用相同的 MEMRI 和副甲状腺素序列来跟踪 1 小时(130Hz 和 200μA)的 DBS 传递。灌注后,对脑切片进行后续 c-Fos 和副甲状腺素免疫染色。
急性单侧 ANT-DBS 显著降低了 Papez 回路的整体锰摄取,从而降低了 MEMRI 对比。此外,c-Fos 表达在扣带皮层和下丘脑后叶双侧增加,这些区域与 ANT 直接相连,以及杏仁核和下丘脑中,这些区域在边缘回路内。
我们的数据表明,MEMRI 可用于检测 DBS 对全脑的反应,因为这里使用的高频刺激参数导致 Papez 回路中的细胞活动显著减少,这可能有助于解释 ANT-DBS 的抗癫痫作用。